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New York Heart Association Class III/IV

MedGen UID:
75902
•Concept ID:
C0278962
•
Finding
Synonyms: NYHA Class III/IV; NYHA III/IV

Definition

The two most severe classes of cardiac dysfunction according to a classification system developed by the New York Heart Association to grade cardiovascular function and disability. These classes are defined as follows: Class III - patients with cardiac disease producing marked limitation of activity: comfortable at rest. Less than ordinary physical activity causes symptoms. Class IV - patients with cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms may be present even at rest. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVNew York Heart Association Class III/IV

Professional guidelines

PubMed

Nationwide Temporal Trends in Clinical Characteristics and Treatment of Dilated Cardiomyopathy From 2003 to 2013 in Japan　- A Report From Clinical Personal Records.
Tsutsui Y, Matsushima S, Enzan N, Noda E, Shinohara K, Hashimoto T, Ide T, Kinugawa S, Tsutsui H
Circ J 2023 Mar 24;87(4):500-507. Epub 2023 Feb 16 doi: 10.1253/circj.CJ-22-0554. PMID: 36792220
Parent-Reported Symptoms and Perceived Effectiveness of Treatment in Children Hospitalized with Advanced Heart Disease.
Molloy MA, DeWitt ES, Morell E, Reichman JR, Brown DW, Kobayashi R, Sleeper LA, Elia EG, Samsel C, Blume ED
J Pediatr 2021 Nov;238:221-227.e1. Epub 2021 Jul 2 doi: 10.1016/j.jpeds.2021.06.077. PMID: 34217766
Impact of Sex on Clinical Course and Survival in the Contemporary Treatment Era for Hypertrophic Cardiomyopathy.
Rowin EJ, Maron MS, Wells S, Patel PP, Koethe BC, Maron BJ
J Am Heart Assoc 2019 Nov 5;8(21):e012041. Epub 2019 Oct 30 doi: 10.1161/JAHA.119.012041. PMID: 31663408Free PMC Article

Recent clinical studies

Etiology

Dose-Blinded Myosin Inhibition in Patients With Obstructive Hypertrophic Cardiomyopathy Referred for Septal Reduction Therapy: Outcomes Through 32 Weeks.
Desai MY, Owens A, Geske JB, Wolski K, Saberi S, Wang A, Sherrid M, Cremer PC, Naidu SS, Smedira NG, Schaff H, McErlean E, Sewell C, Balasubramanyam A, Lampl K, Sehnert AJ, Nissen SE
Circulation 2023 Mar 14;147(11):850-863. Epub 2022 Nov 6 doi: 10.1161/CIRCULATIONAHA.122.062534. PMID: 36335531
Clinical characteristics and 1-year outcomes in hospitalized patients with heart failure with preserved ejection fraction: results from the China Cardiovascular Association Database-Heart Failure Center Registry.
Cai A, Qiu W, Zhou Y, Feng Y, Chen J, Xia S, Li W, Liao Y, Li X, Zhou J, Wang H, Jin W, Zhang Q, Sun Z, Chen M, Wang J, Kong H, Zhang Y, Dong W, Bai L, Xu D, Yuan J, Liu C, Jiang M, Xu Y, Li L, Dong Y, Yang J
Eur J Heart Fail 2022 Nov;24(11):2048-2062. Epub 2022 Sep 11 doi: 10.1002/ejhf.2654. PMID: 36054149
TRI-SCORE: a new risk score for in-hospital mortality prediction after isolated tricuspid valve surgery.
Dreyfus J, Audureau E, Bohbot Y, Coisne A, Lavie-Badie Y, Bouchery M, Flagiello M, Bazire B, Eggenspieler F, Viau F, Riant E, Mbaki Y, Eyharts D, Senage T, Modine T, Nicol M, Doguet F, Nguyen V, Le Tourneau T, Tribouilloy C, Donal E, Tomasi J, Habib G, Selton-Suty C, Raffoul R, Iung B, Obadia JF, Messika-Zeitoun D
Eur Heart J 2022 Feb 12;43(7):654-662. doi: 10.1093/eurheartj/ehab679. PMID: 34586392Free PMC Article
Pertuzumab, trastuzumab, and standard anthracycline- and taxane-based chemotherapy for the neoadjuvant treatment of patients with HER2-positive localized breast cancer (BERENICE): a phase II, open-label, multicenter, multinational cardiac safety study.
Swain SM, Ewer MS, Viale G, Delaloge S, Ferrero JM, Verrill M, Colomer R, Vieira C, Werner TL, Douthwaite H, Bradley D, Waldron-Lynch M, Kiermaier A, Eng-Wong J, Dang C; BERENICE Study Group
Ann Oncol 2018 Mar 1;29(3):646-653. doi: 10.1093/annonc/mdx773. PMID: 29253081Free PMC Article
Atrioventricular Node Ablation.
Gasparini M
Card Electrophysiol Clin 2015 Dec;7(4):749-54. Epub 2015 Sep 12 doi: 10.1016/j.ccep.2015.08.006. PMID: 26596816

Diagnosis

Outcomes of transcatheter aortic valve replacement in patients with cardiogenic shock.
Goel K, Shah P, Jones BM, Korngold E, Bhardwaj A, Kar B, Barker C, Szerlip M, Smalling R, Dhoble A
Eur Heart J 2023 Sep 1;44(33):3181-3195. doi: 10.1093/eurheartj/ehad387. PMID: 37350747Free PMC Article
TRI-SCORE: a new risk score for in-hospital mortality prediction after isolated tricuspid valve surgery.
Dreyfus J, Audureau E, Bohbot Y, Coisne A, Lavie-Badie Y, Bouchery M, Flagiello M, Bazire B, Eggenspieler F, Viau F, Riant E, Mbaki Y, Eyharts D, Senage T, Modine T, Nicol M, Doguet F, Nguyen V, Le Tourneau T, Tribouilloy C, Donal E, Tomasi J, Habib G, Selton-Suty C, Raffoul R, Iung B, Obadia JF, Messika-Zeitoun D
Eur Heart J 2022 Feb 12;43(7):654-662. doi: 10.1093/eurheartj/ehab679. PMID: 34586392Free PMC Article
Left atrial high-grade rhabdomyosarcoma; an unusual location.
Chaturvedi H, Rao RS, Mehta N, Bana A
Asian Cardiovasc Thorac Ann 2021 Nov;29(9):950-952. Epub 2020 Dec 17 doi: 10.1177/0218492320983487. PMID: 33334126
Patient Characteristics Are Not Associated With Documentation of Weight and Heart Failure Related Sign and Symptom Assessment in Skilled Nursing Facilities.
Morrow C, Perraillon MC, Daddato AE, Reeder BP, Wald HL, Battaglia C, Boxer RS
J Am Med Dir Assoc 2021 Jun;22(6):1265-1270.e1. Epub 2020 Oct 16 doi: 10.1016/j.jamda.2020.08.033. PMID: 33071159
Nonobstructive Hypertrophic Cardiomyopathy Out of the Shadows: Known from the Beginning but Largely Ignored … Until Now.
Maron BJ, Rowin EJ, Maron MS, Braunwald E
Am J Med 2017 Feb;130(2):119-123. Epub 2016 Oct 14 doi: 10.1016/j.amjmed.2016.09.015. PMID: 27746287

Therapy

Dose-Blinded Myosin Inhibition in Patients With Obstructive Hypertrophic Cardiomyopathy Referred for Septal Reduction Therapy: Outcomes Through 32 Weeks.
Desai MY, Owens A, Geske JB, Wolski K, Saberi S, Wang A, Sherrid M, Cremer PC, Naidu SS, Smedira NG, Schaff H, McErlean E, Sewell C, Balasubramanyam A, Lampl K, Sehnert AJ, Nissen SE
Circulation 2023 Mar 14;147(11):850-863. Epub 2022 Nov 6 doi: 10.1161/CIRCULATIONAHA.122.062534. PMID: 36335531
Tafamidis: A First-in-Class Transthyretin Stabilizer for Transthyretin Amyloid Cardiomyopathy.
Park J, Egolum U, Parker S, Andrews E, Ombengi D, Ling H
Ann Pharmacother 2020 May;54(5):470-477. Epub 2019 Nov 18 doi: 10.1177/1060028019888489. PMID: 31735059
Pertuzumab, trastuzumab, and standard anthracycline- and taxane-based chemotherapy for the neoadjuvant treatment of patients with HER2-positive localized breast cancer (BERENICE): a phase II, open-label, multicenter, multinational cardiac safety study.
Swain SM, Ewer MS, Viale G, Delaloge S, Ferrero JM, Verrill M, Colomer R, Vieira C, Werner TL, Douthwaite H, Bradley D, Waldron-Lynch M, Kiermaier A, Eng-Wong J, Dang C; BERENICE Study Group
Ann Oncol 2018 Mar 1;29(3):646-653. doi: 10.1093/annonc/mdx773. PMID: 29253081Free PMC Article
Atrioventricular Node Ablation.
Gasparini M
Heart Fail Clin 2017 Jan;13(1):193-198. doi: 10.1016/j.hfc.2016.07.015. PMID: 27886923
Atrioventricular Node Ablation.
Gasparini M
Card Electrophysiol Clin 2015 Dec;7(4):749-54. Epub 2015 Sep 12 doi: 10.1016/j.ccep.2015.08.006. PMID: 26596816

Prognosis

Clinical characteristics and 1-year outcomes in hospitalized patients with heart failure with preserved ejection fraction: results from the China Cardiovascular Association Database-Heart Failure Center Registry.
Cai A, Qiu W, Zhou Y, Feng Y, Chen J, Xia S, Li W, Liao Y, Li X, Zhou J, Wang H, Jin W, Zhang Q, Sun Z, Chen M, Wang J, Kong H, Zhang Y, Dong W, Bai L, Xu D, Yuan J, Liu C, Jiang M, Xu Y, Li L, Dong Y, Yang J
Eur J Heart Fail 2022 Nov;24(11):2048-2062. Epub 2022 Sep 11 doi: 10.1002/ejhf.2654. PMID: 36054149
TRI-SCORE: a new risk score for in-hospital mortality prediction after isolated tricuspid valve surgery.
Dreyfus J, Audureau E, Bohbot Y, Coisne A, Lavie-Badie Y, Bouchery M, Flagiello M, Bazire B, Eggenspieler F, Viau F, Riant E, Mbaki Y, Eyharts D, Senage T, Modine T, Nicol M, Doguet F, Nguyen V, Le Tourneau T, Tribouilloy C, Donal E, Tomasi J, Habib G, Selton-Suty C, Raffoul R, Iung B, Obadia JF, Messika-Zeitoun D
Eur Heart J 2022 Feb 12;43(7):654-662. doi: 10.1093/eurheartj/ehab679. PMID: 34586392Free PMC Article
Pertuzumab, trastuzumab, and standard anthracycline- and taxane-based chemotherapy for the neoadjuvant treatment of patients with HER2-positive localized breast cancer (BERENICE): a phase II, open-label, multicenter, multinational cardiac safety study.
Swain SM, Ewer MS, Viale G, Delaloge S, Ferrero JM, Verrill M, Colomer R, Vieira C, Werner TL, Douthwaite H, Bradley D, Waldron-Lynch M, Kiermaier A, Eng-Wong J, Dang C; BERENICE Study Group
Ann Oncol 2018 Mar 1;29(3):646-653. doi: 10.1093/annonc/mdx773. PMID: 29253081Free PMC Article
Atrioventricular Node Ablation.
Gasparini M
Heart Fail Clin 2017 Jan;13(1):193-198. doi: 10.1016/j.hfc.2016.07.015. PMID: 27886923
Atrioventricular Node Ablation.
Gasparini M
Card Electrophysiol Clin 2015 Dec;7(4):749-54. Epub 2015 Sep 12 doi: 10.1016/j.ccep.2015.08.006. PMID: 26596816

Clinical prediction guides

Frailty and outcomes in heart failure patients from high-, middle-, and low-income countries.
Leong DP, Joseph P, McMurray JJV, Rouleau J, Maggioni AP, Lanas F, Sharma SK, Núñez J, Mohan B, Celik A, Abdullakutty J, Ogah OS, Mielniczuk LM, Balasubramanian K, McCready T, Grinvalds A, Yusuf S
Eur Heart J 2023 Nov 7;44(42):4435-4444. doi: 10.1093/eurheartj/ehad595. PMID: 37639487Free PMC Article
Outcomes of transcatheter aortic valve replacement in patients with cardiogenic shock.
Goel K, Shah P, Jones BM, Korngold E, Bhardwaj A, Kar B, Barker C, Szerlip M, Smalling R, Dhoble A
Eur Heart J 2023 Sep 1;44(33):3181-3195. doi: 10.1093/eurheartj/ehad387. PMID: 37350747Free PMC Article
Dose-Blinded Myosin Inhibition in Patients With Obstructive Hypertrophic Cardiomyopathy Referred for Septal Reduction Therapy: Outcomes Through 32 Weeks.
Desai MY, Owens A, Geske JB, Wolski K, Saberi S, Wang A, Sherrid M, Cremer PC, Naidu SS, Smedira NG, Schaff H, McErlean E, Sewell C, Balasubramanyam A, Lampl K, Sehnert AJ, Nissen SE
Circulation 2023 Mar 14;147(11):850-863. Epub 2022 Nov 6 doi: 10.1161/CIRCULATIONAHA.122.062534. PMID: 36335531
Clinical characteristics and 1-year outcomes in hospitalized patients with heart failure with preserved ejection fraction: results from the China Cardiovascular Association Database-Heart Failure Center Registry.
Cai A, Qiu W, Zhou Y, Feng Y, Chen J, Xia S, Li W, Liao Y, Li X, Zhou J, Wang H, Jin W, Zhang Q, Sun Z, Chen M, Wang J, Kong H, Zhang Y, Dong W, Bai L, Xu D, Yuan J, Liu C, Jiang M, Xu Y, Li L, Dong Y, Yang J
Eur J Heart Fail 2022 Nov;24(11):2048-2062. Epub 2022 Sep 11 doi: 10.1002/ejhf.2654. PMID: 36054149
TRI-SCORE: a new risk score for in-hospital mortality prediction after isolated tricuspid valve surgery.
Dreyfus J, Audureau E, Bohbot Y, Coisne A, Lavie-Badie Y, Bouchery M, Flagiello M, Bazire B, Eggenspieler F, Viau F, Riant E, Mbaki Y, Eyharts D, Senage T, Modine T, Nicol M, Doguet F, Nguyen V, Le Tourneau T, Tribouilloy C, Donal E, Tomasi J, Habib G, Selton-Suty C, Raffoul R, Iung B, Obadia JF, Messika-Zeitoun D
Eur Heart J 2022 Feb 12;43(7):654-662. doi: 10.1093/eurheartj/ehab679. PMID: 34586392Free PMC Article

Recent systematic reviews

Outcome after percutaneous edge-to-edge mitral repair for functional and degenerative mitral regurgitation: a systematic review and meta-analysis.
Chiarito M, Pagnesi M, Martino EA, Pighi M, Scotti A, Biondi-Zoccai G, Latib A, Landoni G, Mario CD, Margonato A, Maisano F, Feldman T, Alfieri O, Colombo A, Godino C
Heart 2018 Feb;104(4):306-312. Epub 2017 Jun 29 doi: 10.1136/heartjnl-2017-311412. PMID: 28663365
Contemporary outcomes after surgical aortic valve replacement with bioprostheses and allografts: a systematic review and meta-analysis.
Huygens SA, Mokhles MM, Hanif M, Bekkers JA, Bogers AJ, Rutten-van Mölken MP, Takkenberg JJ
Eur J Cardiothorac Surg 2016 Oct;50(4):605-616. Epub 2016 Mar 29 doi: 10.1093/ejcts/ezw101. PMID: 27026750Free PMC Article
Predictors of mortality in chronic Chagas disease: a systematic review of observational studies.
Rassi A Jr, Rassi A, Rassi SG
Circulation 2007 Mar 6;115(9):1101-8. doi: 10.1161/CIRCULATIONAHA.106.627265. PMID: 17339568

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